Cost-effectiveness of home telemonitoring in chronic kidney disease patients at different stages by a pragmatic randomized controlled trial (eNephro): rationale and study design

Background Home telemonitoring has developed considerably over recent years in chronic diseases in order to improve communication between healthcare professionals and patients and to promote early detection of deteriorating health status. In the nephrology setting, home telemonitoring has been evalu...

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Bibliographic Details
Published in:BMC nephrology Vol. 18; no. 1; pp. 126 - 9
Main Authors: Thilly, Nathalie, Chanliau, Jacques, Frimat, Luc, Combe, Christian, Merville, Pierre, Chauveau, Philippe, Bataille, Pierre, Azar, Raymond, Laplaud, David, Noël, Christian, Kessler, Michèle
Format: Journal Article
Language:English
Published: London BioMed Central 05.04.2017
Springer Nature B.V
BMC
Subjects:
Blood pressure
Blood Pressure Determination
Body Weight
Chronic illnesses
Chronic kidney disease
Clinical Laboratory Services
Clinical Research
Communication
Cost analysis
Cost-Benefit Analysis
Cost-effectiveness evaluation
Delivery of Health Care - economics
Delivery of Health Care - methods
Dialysis
Disease Management
Electronic Health Records
Expenditures
France
General Practice
Health care access
Hemoglobin
Home telemonitoring
Hospitals
Human health and pathology
Humans
Information technology
Internal Medicine
Internet
Kidney diseases
Kidney Failure, Chronic - physiopathology
Kidney Failure, Chronic - therapy
Kidney Transplantation
Kidney transplants
Life Sciences
Medical research
Medicine
Medicine & Public Health
Mortality
Nephrology
Patients
Peritoneal dialysis
Physician-Patient Relations
Population
Quality of life
Renal Dialysis
Renal Insufficiency, Chronic - economics
Renal Insufficiency, Chronic - physiopathology
Renal Insufficiency, Chronic - therapy
Severity of Illness Index
Studies
Study Protocol
Symptom Assessment
Telemedicine
Telemedicine - economics
Telemedicine - methods
Transplantation
Transplants & implants
Urology and Nephrology
Home telemonitoring
Chronic kidney disease
Dialysis
Cost-effectiveness evaluation
Telemedicine
Kidney transplantation
ISSN:1471-2369, 1471-2369
Online Access:Get full text
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Summary:Background Home telemonitoring has developed considerably over recent years in chronic diseases in order to improve communication between healthcare professionals and patients and to promote early detection of deteriorating health status. In the nephrology setting, home telemonitoring has been evaluated in home dialysis patients but data are scarce concerning chronic kidney disease (CKD) patients before and after renal replacement therapy. The eNephro study is designed to assess the cost effectiveness, clinical/biological impact, and patient perception of a home telemonitoring for CKD patients. Our purpose is to present the rationale, design and organisational aspects of this study. Methods eNephro is a pragmatic randomised controlled trial, comparing home telemonitoring versus usual care in three populations of CKD patients: stage 3B/4 ( n  = 320); stage 5D CKD on dialysis ( n  = 260); stage 5 T CKD treated with transplantation ( n = 260). Five hospitals and three not-for-profit providers managing self-care dialysis situated in three administrative regions in France are participating. The trial began in December 2015, with a scheduled 12-month inclusion period and 12 months follow-up. Outcomes include clinical and biological data (e.g. blood pressure, haemoglobin) collected from patient records, perceived health status (e.g. health related quality of life) collected from self-administered questionnaires, and health expenditure data retrieved from the French health insurance database (SNIIRAM) using a probabilistic matching procedure. Discussion The hypothesis is that home telemonitoring enables better control of clinical and biological parameters as well as improved perceived health status. This better control should limit emergency consultations and hospitalisations leading to decreased healthcare expenditure, compensating for the financial investment due to the telemedicine system. Trial registration This study has been registered at ClinicalTrials.gov under NCT02082093 (date of registration: February 14, 2014).
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PMCID: PMC5381043
ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-017-0529-2